Individual provider Active NPI

Cliff J. Ireland, D.O.

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1952365116
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036071364 Issued in IL
Practice address
4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1425
Phone
(847) 679-6707
Fax
(847) 679-6721
NPI assigned
Apr 14, 2006
Last updated
May 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036071364 IL Primary

Addresses

Primary practice location

4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1425

Mailing address

4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1425
Phone (847) 679-6707

Other identifiers 1

IdentifierTypeStateIssuer
01621317OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000103 IL Practitioner - Internal Medicine 7214821867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4905 Old Orchard Ctr Level
Skokie, IL 60077-1458
Phone (847) 679-6707

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
C J Ireland D O S C Internal Medicine CurrentSince Sep 1, 1997 Accepting new patients
Orchard Group Inc Internal Medicine Past Accepting new patients
Midwest Palliative & Hospice Carecenter Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1952365116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "LOWER LEVEL",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771425",
            "telephone_number": "847-679-6707",
            "fax_number": "847-679-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "LOWER LEVEL",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771425",
            "telephone_number": "847-679-6707",
            "fax_number": "847-679-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRELAND",
        "first_name": "CLIFF",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036071364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01621317",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.